Abstract

Introduction:
Ursodeoxycholic acid (UDCA) therapy attenuates the risk of biliary pain and complications in patients with symptomatic gallstones [1]. However, it is unknown whether UDCA therapy might improve also the gastrointestinal quality of life in patients with “asymptomatic” cholecystolithiasis.
Methods:
Therefore we studied the effect of UDCA treatment in 35 patients [ ♀ = 21; age 36 – 72, av. 56.6; ♂ = 14; age 29 – 78, av. 59,8 ] with “asymptomatic” gall-stones, using the „Gastrointestinal Quality of Life Index“ (GIQLI) as previously introduced by Eypasch et al. [2] The 36 questions of the GIQLI had to be answered on a 5-digit scale (0;1;2;3;4), so if added up a total score of 144 could be obtained. The questionnaire was answered before and after a four-week treatment with 250 mg UDCA per day, taken in the evening.
Results:
The patients scored 107.0 ± 15.9 (mean ± SD ) points from an attainable maximum of 136* prior UDCA treatment, which increased significantly ( p < 0,01 ) to 119.0 ± 12.5 points after UDCA application. Five patients already had a high GIQLI-score ( 120↑) before the treatment with UDCA, which is indicating, that the innocent gall-stone is not a myth. The change of the GIQLI-score between the two measurements ranged from – 6 to + 50 points. 8 patients with an initial GIQLI-score ≤ 100 gained significantly more points ( p < 0,01 ) ( 22.5 ± 16.6 ), than the 27 patient with an initial GIQLI-score >100 ( 8.67 ± 6.84 ).
Conclusions:
Our study shows that a “silent gall-stone” is not always as silent as expected, and that furthermore a treatment with low dose UDCA can improve the gastrointestinal quality of life in patients with “asymptomatic” cholecystolithiasis, particularly in patients with an initial GIQLI-score ≤ 100 points.
References: [1] Tomida S. et al. Hepatology 1999; 30: 6-13
[2] British Journal of Surgery 1995; 82: 216-222